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How Much Money is Your Practice Losing Due to Medical Coding?

May 18, 2017

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Owning a medical practice used to be much easier, before additional paperwork and regulation started flying at you from all directions. Unfortunately, today’s medical practices suffer from significant inefficiencies due to manual processes in the office. Worse yet, revenue cycles are often disrupted because of slow payments, write-offs and poor medical coding procedures. How can you bring efficiency back to your front office and ensure that your practice is as fruitful as possible?


Some experts believe that a single practice may lose up to $40,000 through downcoding alone on an annual basis. Being cautious when you’re manually coding patient visits may mean that you’re essentially undercharging patients and insurance companies for the services that you’re providing — a widespread practice in the medical industry meant to reduce the possibility of an audit. One of the most effective ways to reduce downcoding is to move to an electronic health record (EHR) system, as coding recommendations are made for you on the fly based on the statistics of the visit. Utilizing an EHR system can also help during an audit, as all of the pertinent details are captured within the electronic record system.

Charge Capture

Entering accurate charges are difficult when all of the appropriate procedure and diagnosis codes are not being captured, and this is a challenge in practices of all sizes. With ever changing medical coding guidelines, it could be due to lack of training or negligence by your medical billing staff. If the charges are not captured accurately on an intake form then you’re risking reduced revenue. System generated charge capture forms may be the most efficient but can also be missing critical details. If your practice is utilizing electronic charge forms, it’s important that you’re using ones that can be edited real-time to add additional information.

Related Article: Risks Related to Medical Billing Providers Must Know!

Claims Transmission

Transmitting your claims to third-party payers or via a clearinghouse results in a majority of claims running right through — but some percentage of claims will be rejected. The reason for rejection may be simple (missing or mismatched customer data) or complex (data entry errors), but working any rejection reports quickly will keep your office from falling behind and risking these claims falling through the cracks.

Accounts Receivable and Collections

Having a team member dedicated to confirming accounts receivable and collections and working closely with third-party payers to get them resolved as quickly as possible can cause a significant (and positive) shift in your revenue cycle. Collections efforts should be prioritized, with older or high value accounts getting the most attention. With collection efforts, it’s incredibly important to document each step and to have a trustworthy team working through these issues. Collection letters and calls should be highly standardized, and follow a strict script to maintain consistency. Janice Crocker, MSA, RHIA, CCS, CHP of AHiMA notes that developing a highly-structured and aggressive collection process will ensure that your practice has the working funds available to provide the best possible service to all of your patients.

Poor Staffing Levels

Staffing can be challenging on many levels. On one hand, if you don’t have enough staff available in your office to work with patients, you’re unlikely to offer good service and may lose patients to competitors. However, if you’ve overstaffed and have a lot of wasted hours in your day, this staff time is incredibly expensive and makes up a large portion of your daily expenses. Moving patients quickly and efficiently through the entire process within your practice takes balance and impeccable timing of everything from breaks to lunches. Paying overtime is another line-item where you can significantly reduce your overhead. If you require your staff to get approval before they work overtime, you’re more likely to get compliance on this particular rule.

If you’re ready to maximize your profits and minimize your coding headaches, contact M-Scribe Technologies, LLC today. Our professional and proactive team of coders and billers will work with you to define an EHR process that’s right for your specific specialty. Contact us today at 888-727-4234 or email to learn more.


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